Diagnosing Autism in Psychiatry: It’s Giving ‘You Don’t Look Autistic'

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Autism has long been boxed into a narrow stereotype—white, male, socially awkward, obsessed with trains. But what about the autistic people who don’t fit that mold? The girl who made it to adulthood without a diagnosis because she was “just shy”? The high-achieving professional who burns out repeatedly but is told they’re just anxious? The Black kid who gets labeled as “defiant” instead of supported? The adult who spent years self-medicating with alcohol or drugs because they were never given the right framework to understand themselves?

In this episode of Brain Trash, we’re breaking down the DSM’s diagnostic criteria for autism, point by point, and exposing just how many people slip through the cracks. We’ll dig into how sensory sensitivities, social differences, and repetitive behaviors manifest in ways that aren’t always obvious—especially in those who mask or were forced to adapt from a young age. From hyper-empathy to burnout, camouflaging to substance use, we’ll explore the many ways autism can present that the DSM fails to capture, and why this misunderstanding has real, harmful consequences.

If you’re a clinician who works in mental health or you’re a person who questioned neurodivergence to your provider only to get shot down because you don’t “look” autistic, then you better have a seat and pop on your headphones.  Don’t miss our deep dive into how the DSM leads clinicians to the stereotypical presentations. Subscribe and leave any questions or thoughts!

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